The Effect of Illness Acceptance and Adaptation on Symptom Management in Hemodialysis Patients: A Study Based on the Roy Adaptation Model

Objective: Hemodialysis is the most common renal replacement therapy for end-stage renal disease. Adherence to diet, fluid restriction, medication, and dialysis sessions affects symptom experience. This study aimed to examine the impact of disease acceptance and treatment adherence on symptom burden in hemodialysis patients within the Roy Adaptation Model (RAM) framework. Methods: This descriptive and cross-sectional study was conducted with 182 patients receiving treatment at a private dialysis center in İzmir, Türkiye, between February and September 2025. Data were collected using the Patient Information Form, the Acceptance of Illness Scale (AIS), the End-Stage Renal Disease Adherence Questionnaire (ESRDAQ), and the Dialysis Symptom Index (DSI). Data were analyzed using SPSS, version 21. Correlation and regression analyses were performed to assess relationships among variables. Results: More than half of the participants were between 45 and 59 years of age, and the gender distribution was nearly equal. The mean scores were 712.28 ± 225.77 for the ESRDAQ, 25.36 ± 7.77 for the AIS, and 83.88 ± 28.94 for the DSI. A strong positive correlation was found between ESRDAQ and AIS (r=0.970), while strong negative correlations were observed between ESRDAQ and DSI (r=−0.974), and between AIS and DSI (r=−0.996). Conclusion: Greater illness acceptance and treatment adherence reduce symptom burden in hemodialysis patients. Based on the RAM, nursing interventions should strengthen patients’ cognitive, physiological, and role–function adaptation.